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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700808
Report Date: 04/15/2024
Date Signed: 04/24/2024 10:29:46 AM

Document Has Been Signed on 04/24/2024 10:29 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197700808
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/15/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:37 PM
MET WITH:Rosaura MartinezTIME VISIT/
INSPECTION COMPLETED:
03:04 PM
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On 4.15.24, LPA Diaz conducted a visit to observe corrections from the Pre-Licensing appointment.

LPA observed sensors on all windows and doors leading to the pool area. 3 of 5 windows do not open at all. The sliding door has a sensor/alarm when opened. LPA observed a self-latching, self-closing mechanism on the gate. LPA reminded applicant to place lock on the gate. LPA observed a lock on the first aid kit in the childcare room. LPA observed a safety gate to make the kitchen and living room inaccessible.

Home is ready for licensing.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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